Individual provider Active NPI

Heather Stephanie McMillen, CRNA

  • Certified Registered Nurse Anesthetist
  • Ballwin, MO
National Provider Identifier
1366770117
Registry record updated Feb 14, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
089666 Issued in MO
Practice address
339 Consort Dr
Ballwin, MO 63011-4439
Phone
(503) 851-7603
NPI assigned
Dec 4, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 14, 2013

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 089666 MO Primary

Addresses

Primary practice location

339 Consort Dr
Ballwin, MO 63011-4439

Mailing address

4460 Gibson Ave
Saint Louis, MO 63110-1614
Phone (503) 851-7603

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200814000046 OR Practitioner - Certified Registered Nurse Anesthetist (Crna) 5294997748 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Oregon Health Sciences University School of Medicine, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Santiam Memorial HospitalGroup PAC ID 6103729751, 128 clinicians

Practice addresses (Care Compare)

1401 N 10TH Ave
Stayton, OR 97383-1311
Phone (503) 769-2175

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
089666MOMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Santiam Memorial Hospital CurrentSince May 25, 2020 Accepting new patients
Santiam Memorial Hospital CurrentSince May 25, 2020 Accepting new patients
Santiam Memorial Hospital Current Accepting new patients

Locations

1375 N 10th Ave
Ste B
Stayton, OR 97383
Phone (503) 769-7546

1401 N 10th Ave
Stayton, OR 97383
Phone (503) 769-2175

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1259884800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1360800000000",
    "number": "1366770117",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4460 GIBSON AVE",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631101614",
            "telephone_number": "503-851-7603"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "339 CONSORT DR",
            "city": "BALLWIN",
            "state": "MO",
            "postal_code": "630114439",
            "telephone_number": "503-851-7603"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCMILLEN",
        "first_name": "HEATHER",
        "middle_name": "STEPHANIE",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-12-04",
        "last_updated": "2013-02-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MO",
            "license": "089666",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ballwin, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 14, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.